432 Radiation Prosthesis for Improving the Life of Cancer Patients Harisha Dewan* Department of Prosthetic Dental Sciences, Jazan University, Kingdom of Saudi Arabia *Corresponding author: Harisha Dewan, Department of Prosthetic Dental Sciences, Jazan University, Kingdom of Saudi Arabia. To Cite This Article: Harisha Dewan. Radiation Prosthesis for Improving the Life of Cancer Patients. Am J Biomed Sci & Res. 2019 - 4(6). AJBSR. MS.ID.000849. DOI: 10.34297/AJBSR.2019.04.000849 Received: August 16, 2019; Published: August 26, 2019 Introduction While radiotherapy for malignant tumors of the head and neck region is effective in tumor control, late complications often occur in the mouth. Side effects of concern for prosthetic dentistry are [1]: thinning of membranes and telangiectasia capillary tube extension, bone exposure and osteoradionecrosis, salivary-gland damage and fibrosis of the skin and sub membranous tissues. In addition to the use of radioprotective drugs like palifermin, benzylamine mouthwash [2], a Prosthodontist can help by the fabrication of radiation stents which can protect normal tissues from radiation injury. This article presents a review of the current applications of these devices which can help to prevent the unnecessary irradiation of surrounding normal tissues, thus reducing the severity of the reaction and throws light on their fabrication, uses and, importance. Materials Used to Fabricate Radiation Stents The most common material used for stent construction is heat cure acrylic resin. Cerrobend (bismuth50% lead-26.7%, tin- 13.3%, cadmium-10%) is the most commonly used shielding alloy, which has a low fusing temperature (158F) [3]. It has a melting temperature of 140 F and hence it can be melted and poured into the cavity prepared, blocked out with clay and backscatter prevented by auto polymerizing MMA resin. Cancer patients mostly are treated at 1.8-2 Gy per fraction and the treatment lasts from 4 to 7 weeks. This type of schedule is called a conventional fractionation schedule and uses external beam radiation, internal beam radiation or modern radiotherapy [4]. One cm thickness of Lipowitz alloy will effectively reduce an 18MeV electron beam by approximately 95%. The walls of the reservoir should be at least 0.5% thick to prevent backscatter of radiation [5]. The conventional technique, which is the facial moulage, is commonly used to fabricate these stents. Nowadays, computer-aided designing/computer-aided manufacturing (CAD/CAM) and rapid prototyping technologies have been used for the same [6]. Prosthesis in Radiotherapy Many prostheses made by the dentist help the radiotherapist in treating patients with malignancies of oral and para oral tissues [7]. They can be divided into the following types [5]: (Figure 1) Radiation carriers or surface applicators mostly use capsules, beads, tubes or needles made of a radioactive element such as radium 226, iridium192 or cesium132. They can carry the radiation sources close to the site of treatment (intracavitary) or directly into the tumor (interstitial). They are of two types; preloaded carriers and after loaded carriers [8]. A pre-loaded carrier incorporates the radioactive material like iridium seeds within a smaller diameter polyethylene tube which is then incorporated within the stent and Cerrobend shield is added. In an after-loaded carrier, the radioactive elements are placed after the carrier is in position, which reduces radiation exposure. This technique is used for both interstitial and intracavitary radiotherapy and is the preferred technique. A Position maintaining stent displaces the movable tissues like the lips, tongue, cheeks and soft palate away from or towards the source of radiation [9]. A Perioral cone positioning stent holds the intraoral cone in a definite position and places the tongue away from the field of irradiation [10,11]. A Radiation measuring stent/ Dosimeter positioning stent contains lithium fluoride capsules that enable the radiotherapist to measure radiation received by tissues Copy Right@Harisha Dewan This work is licensed under Creative Commons Attribution 4.0 License AJBSR.MS.ID.000849. American Journal of Biomedical Science & Research www.biomedgrid.com --------------------------------------------------------------------------------------------------------------------------------- ISSN: 2642-1747 Mini Review Abstract Cancer, one of the non-communicable diseases, is amongst the major public health problems in India. Radiotherapy is being used as an adjunctive form of treatment in the management of head and neck cancer. Adverse tissue reactions are associated with the use of radiotherapy in the management of patients with head and neck cancer. With a proper oral hygiene and dental care program, protective radiation prostheses can help reduce the morbidity seen with existing radiotherapy regimens. Keywords: Radiotherapy; Radiation prostheses